Article

Obsessive-Compulsive Disorder in the Media

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Abstract

Scholars have long been concerned that mass media depictions of those with mental disorders foster stigma. Research is needed extricating how particular disorders are represented and perceived, such as obsessive-compulsive disorder (OCD). This article examines what images of obsessions and compulsions exist in the media, and how persons interpret these. It employs two methods: qualitative in-depth interviews and content analysis. Data indicate the media represents obsessions and compulsions in distinguishable ways that both reinforce and complicate common media stereotypes of those with mental disorders—fostering a stigma hierarchy and having contradictory effects on mental health literacy.

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... On the one hand, as reported above, only a few studies have analyzed the MHL about OCD, and these studies have focused on contamination OCD. However, rates of identification could be much lower for other OCD manifestations that have not received as much attention in the mass media (Cathey and Wetterneck, 2013;Fennell and Boyd, 2014). Moreover, research shows that contamination OCD seems to be less associated with stigma than other manifestations. ...
... The identification of aggression/harm symptoms by less than a quarter of the participants was lower than adolescents' recognition rates of other disorders, such as depression (Burns and Rapee, 2006;Coles et al., 2016). Differences found in the recognition rates of aggression symptoms and ordercontamination symptoms could be partly explained by the fact that order and contamination are the OCD symptoms most frequently addressed in the mass media, for example, in television series and movies (Cathey and Wetterneck, 2013;Fennell and Boyd, 2014). Results also show that participants seem to confound the aggression-OCD vignette with schizophrenia. ...
... Finally, it is worth mentioning that almost 14% of the adolescents felt that there was no need for treatment for order-related OCD, even though the high level of interference was explicit in the vignette. This result could be due to the media's portrayal of OCD symptoms as funny habits rather than symptoms to be treated (Fennell and Boyd, 2014), or to the normalcy of order in daily life, as to some degree, order-related OCD is perceived as a desirable condition (e.g., being a tidy and organized person). ...
Article
Obsessive-compulsive disorder (OCD) is a frequent and disabling disorder with a long delay in seeking help that could partly be due to poor mental health literacy and stigmatizing attitudes. This study analyzes the mental health literacy and stigma associated with symmetry/order and aggression-related OCD in a Spanish adolescent sample. This age group was chosen because adolescence is a vulnerable period for the development of OCD, and adolescents are often reluctant to seek professional help. One hundred and two non-clinical adolescents read two vignettes describing symmetry/order and aggression-related OCD. Then, referring to these two vignettes, they answered questions related to problem recognition, causality perception, need for treatment, treatment recommendations, and stigma. Results show that a high percentage of adolescents recognize the interference of order- and aggression-related OCD, consider that a peer with order- or aggression-related OCD needs treatment, and would recommend a formal source of help. Although order symptoms are highly recognized as OCD by adolescents, aggression-related OCD is frequently misidentified as schizophrenia or depression. Results also show higher levels of stigmatizing attitudes in adolescents, associated with aggression-OCD (versus order-OCD), especially in male adolescents and adolescents with no previous experience with mental health services/providers. Results suggest the need to develop school-based programs emphasizing OCD content heterogeneity, especially the aggression, sexual, and religious contents, and work toward eliminating stigma.
... This situation causes environmental support to fail. As with all other illnesses, it is important that environmental support is available to deal with the disease during the treatment process [60]. Concerns about accusations and exclusion by those who are close to the family in relation to other people cause problems and distances away from others [1,61]. ...
... TV programs and publications have been reported to have positive effects on stigma [102]. A study on media reported that the Monk character, an individual with OCD, reduced stigma against OCD [60]. In the technology world, there are many people who reach through social media and individuals can be encouraged to tell their stories by digital storytelling methods. ...
... Consider the example of the lead in the TV series Monk, a homicide detective with a diagnosis of obsessive compulsive disorder (OCD), who seemingly uses his mental illness to his advantage as he meticulously solves perplexing cases. Portrayals of OCD in the media, as in Adrian Monk's case, tend to highlight characters that are highly functional and intelligentcontributing to society in sometimes extraordinary ways (Fennell & Boyd, 2014). While stigmatization of a disease traditionally makes others desire more social distance, as explained by Goffman's (1963) association of stigmatization with dehumanization, the present research suggests that trivialization is a different process, one where individuals perceive a condition to actually be a benefit to those affected. ...
... The aforementioned review of stigma literature serves as the foundation for which to begin conceptualizing a related but distinct concept of trivialization. The perception that certain symptoms of trivialized mental illnesses may be perceived as a benefit stems from a review of recent literature on advantageous traits related to mental disorders (Fennell & Boyd, 2014), as well as various anecdotal evidence found within discussions on social media. Consider the colloquial use of "that's so OCD" and "I'm a little OCD" in pop culture that has been equated to positive life practices regarding cleanliness and organization skills (Gonzalez, 2015). ...
Article
Much of the extant research on representations of mental illness in the media have focused on stigmatization. The negative effects of these stigmatizing portrayals on individuals with mental illness are serious. However, recent scholarship has identified another phenomenon in the mediated portrayal of mental illness whereby these conditions are trivialized. As opposed to stigmatizing portrayals that make people with mental illness seem violent and incompetent, media portrayals that trivialize mental illnesses often treat the symptoms of these conditions (e.g., organizational ability for people with obsessive compulsive disorder or high energy levels for people with attention-deficit/hyperactivity disorder) as benefits, thereby diminishing the seriousness of these conditions. The aim of the present study was to develop a reliable and valid scale for assessing how individuals perceive symptoms of mental illnesses as benefits (and, thereby, trivialize these illnesses). Results across three studies support the existence of a reliable and valid measure whereby symptoms demark individuals with a mental illness as receiving a benefit. By establishing this scale, researchers will be better suited to assess the potential intersections and interaction of processes related to mental illness trivialization and stigmatization, both through media portrayals and through everyday interactions.
... Not only is Schizophrenia widely known to be poorly received by the public (e.g., Jorm & Oh, 2009), but media depictions of individuals with Schizophrenia are also terribly negative, including how individuals with Schizophrenia are depicted in movies/entertainment, where they are usually presented as violent (e.g., Owen, 2012). Although media depictions of OCD are not accurate portrayals of individuals who suffer with the disorder, individuals with OCD, in contrast to individuals with Schizophrenia, are generally depicted as intelligent functional members of society (Fennell & Boyd, 2014), which may help form more positive attitudes towards individuals with OCD than to individuals with other disorders. Thus, although media depictions of OCD may not be accurate, it is possible they are more positive. ...
... Crime control policy is no different. And while there is no shortage of examples of a mismatch between the public"s knowledge and the scientific consensus, and of media portrayals that depart from scientific reality (Fennell and Boyd 2014;Griffin et al. 2013), one that is particularly illustrative is Scared Straight programs. The original Scared Straight documentary was based on Juvenile Awareness Project Help (JAPH), a program developed in New Jersey"s Rahway prison in 1975 as an intervention for high-risk delinquent youth (Finckenauer 1982). 1 The idea was to take a group of delinquents-most of whom would be drawn from communities plagued by structural disadvantage-into prison for a day to have a bunch of adult inmates yell at them and tell them in graphic detail all of the horrific things that await them should they ever be sentenced there (Feinstein 2005;Sellers 2015). ...
Article
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Americans’ opinions about crime and justice are more often shaped by media coverage than by scientific evidence. A prime example of this phenomenon is Arts and Entertainment (A&E) Network’s Beyond Scared Straight program—a show that has achieved strong ratings despite the large body of empirical evidence demonstrating the ineffectiveness inmate-juvenile confrontation tactics. To understand the complexity of American citizens’ opinions towards this program, we conducted a qualitative analysis of the online responses to the television series Beyond Scared Straight. The themes that emerged center around beliefs about the effectiveness of Scared Straight, the level of brutality displayed, its inspirational and emotional content, and its authenticity. We discuss these results in terms of the need for scholars to more effectively communicate social science information concerning what does—and does not—“work” to the public and to correctional policymakers.
... Studies examining obsessive-compulsive disorder (OCD) in fictional media revealed a rather more positive picture than for mental illness in general. Fennell and Boyd (2014) content analyzed fictional media representations of OCD from 1970s to 2000s. The data indicated that though the media image of OCD reinforced some common negative stereotypes of mental illness, the media also portrayed people with OCD as relatively intelligent and functional. ...
Article
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Purpose Mental illness has become an important public health issue in society, and media are the most common sources of information about mental illnesses. Thus, it is important to review research on mental illnesses and media. The purpose of this paper is to provide a narrative review of studies on mental illnesses in the media and identifies important research gaps. Design/methodology/approach A combination of searching key databases and examining reference lists of selected articles was used to identify relevant articles. In total, 41 empirical studies published in the last 12 years were reviewed. Findings The review found that substantial research had been done to investigate media portrayals of mental illnesses and the effects of such portrayals might have on the public. Media still portray mental illnesses negatively in general, which contributes to the ongoing mental illness stigmatization. Nonetheless, discussions of mental illnesses in direct-to-consumer advertisements and social media tend to be more objective and informative. These objective portrayals could help improve mental health literacy and reduce stigma. More importantly, media can also reduce the stigma if used strategically. Research has found that entertainment-education programs and web-based media have strong potential in reducing mental illness stigma. Recommendations for future research are also discussed. Practical implications Findings can guide future efforts to use media to educate the public about mental illnesses and reduce mental illness stigma. Originality/value This study reviews the most recent research on mental illnesses in the media and provides important references on the media representation of mental illnesses, media effects of such representation, and using media to reduce stigma.
... Given the identity-forming effect of media (Fennell and Boyd 2014) and the impact of the media in regards to the perceptions of coping with mental health challenges (Sieff 2003), the depictions of tattooing practices in the wake of trauma may reflect and emphasize emerging and culturally desirable ways of coping with trauma. The narratives presented here are more than individual stories of suffering and healing; they described personal stories of suffering becoming public tales of coping, making them visible and, in a way, collective stories with which one can easily identify. ...
Article
Growing numbers of trauma survivors have chosen to cope with their ongoing invisible wounds through tattooing their bodies. This phenomenon includes individuals as well as organized and documented projects held in public spaces. The topic of body modification through tattoos has benefited from an explosion in academic interest; however, there has been little scholarly attention directed at examining how tattoo practices may be understood as a means of coping with trauma within a contemporary cultural context. While drawing on psychological and cultural studies’ perspectives we explored the meanings attributed to tattoos by trauma survivors. Analyzing documented personal accounts of tattooed survivors in different countries, we illustrated how being tattooed appears to be a personal way of coping with trauma as well as a cultural practice of meaning making. The meanings attributed by trauma survivors’ included: exposing their trauma for recognition, witnessing, meaningfulness of the tattoo, connection, control, and transformation. The meaning-making process appears to be continuous and dynamic, shaped by psychological responses, social interactions, and cultural narratives.
... Also, in children's programming, characters without a mental illness typically fear, exclude, and disrespect characters with a mental illness (Wahl, Hanrahan, Karl, Lasher, & Swaye, 2007). However not all depictions are negative; portrayals of people with obsessive-compulsive disorder (OCD) in fictional media often are positive with characters appearing intelligent (Fennell & Boyd, 2014;Siegel, 2014). ...
Article
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This study investigated viewer responses to characters from Silver Linings Playbook, a movie about characters dealing with mental illness, from the perspective of mediated intergroup contact hypothesis. Researchers tested if identification with fictional characters with mental illness reduced viewers’ negative stereotypes about mental illness and increased their willingness to support people with the same illnesses as the characters. Additionally, empathy was tested as a mediator between identification and stereotype reduction. One hundred forty-five participants were randomly assigned to 1 of 3 character conditions. The hypotheses associated with identification and stereotypes and intentions were partially supported. For two characters, empathy mediated the relationship between identification and negative stereotypes. Implications for mediated portrayals of health issues and behaviors are discussed.
... While trivialization has been noted by individuals with OCD as a common attribute of experienced stigma (Fennell & Boyd, 2014), evaluations of the endorsement of this stigma attribute were not available in the current literature. Future evaluations of the anxietyspecific stigma that map onto trivialization and perceptions of weakness (e.g., Skidmore Anxiety Stigma Scale; Schofield & Ponzini, 2020) may further elucidate differences in the public stigma attributes associated with symptom subtypes. ...
... Since the complex, intrasubjective thinking patterns of the characters are never visually represented, the audience does not understand the rationale behind the incongruous behaviour and are left with an oversimplified caricature of OCD. As a result, these comic representations of OCD create stereotypes that, on the one hand, downplay the real challenges that sufferers have to face, and on the other hand, reinforce the denigratory idea that everyone "is a little bit OCD" (Fennell and Boyd 2014). Rose's story challenged these stereotypes by expanding OCD into the realm of sexuality. ...
Thesis
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This study is broadly an exploration of how people who suffer from sexual orientation OCD (SO-OCD) and gender identity OCD (GI-OCD) use language to construct their identity, and how that process is framed by (hetero)normative idealogies. Instead of writing the abstract of the study (which you can find on page 4), I will highlight the different chapters that might be the most interesting for different readers: PSYCHOLOGISTS WORKING ON OCD should especially read: - CHAPTER 1 where I review the literature on OCD, and especially section 1.4 where I identify the gap my project fills. - CHAPTER 3 where I operationalize the concept of the feared self not as a fixed cognitive construct, but one that is discursively negotiated through language. - CHAPTERS 6-9 a detailed analysis of OCD sufferers' language use and how they construct their identity by distancing themselves from their feared self. - CHAPTER 10 is really where my argument comes together. I interpret the linguistic findings from chapters 6-7 through queer theory and Foucauldian self-governmentality. I especially argue that by distancing from a feared self, OCD sufferers run towards what I call an "idealized pure self" that is always and only the identity they wish to embody. This idealized self is constituted by a strong adherence to heteronormative understandings of gender and sexuality. The idea of a "pure self" is inscribed withing a sociocultural frame that has constructed sexuality as the locus of the "true self". In addition, I challenge the assumption that homophobia is the sociocultural factors causing SO-OCD. I demonstrate that this assumption doesn't account for LGBTQA+ OCD sufferers who obsess about being not LGBTQA+. As such, I suggest to conceptualize OCD not as a fear of "becoming" something that is socially taboo, but rather as a fear of "losing" something that is socially cherished. This fear of becoming or losing are two sides of the same coin that are shaped by (hetero)normative Discourses. Thus, the sociocultural factor shaping SO-/GI-OCD fears is argued to be tied to the notion of normativity. - CHAPTER 11: summarizes the whole study and section 11.3 explicitly states the contributions to the research on OCD SOCIOLINGUISTS INTERESTED IN LANGUAGE, GENDER, SEXUALITY & CORPUS LINGUISTICS should read: - Chapter 2 reviews Foucault's work on self-governmentality, queer theory and how all of this can be operationalized through linguistics - One of the major contributions of my thesis to sociolinguistics is a methodological one. In fact, I triangulated corpus-assisted discourse analysis with ethnographic approaches. Chapter 4 describes how I constructed a forum and conducted a 18 month long ethnography (or netnography), and CHAPTER 5 describes the methodic steps in my analysis. - CHAPTERS 6-9 are a detailed accounts of my participants' language use. - CHAPTER 10 interprets the findings through queer theory (see above), and section 10.5 suggests an additional way to conceptualize normativity in the field of language, gender and sexuality. - CHAPTER 11 gives a summary of everything, and sections 11.4 and 11.5 explicitly highlight the contributions to sociolinguistics and avenues for future research.
Article
This article explores destigmatization discourses in the United States in the early 21st century, as social and political strategies and as narrative social movements unto themselves. We argue that the first decades of the new century see a trend of marginalized actors across many categories, including queer marriage, drugs, (discreditable) mental illness and (discredited) other areas of identity and disability, make narrative attempts to neutralize their “deviant” identities. We argue that de-stigmatization has occurred through the successful use of medicalization and assimilation framing of de-stigma discourses. Assimilationist frames increase “liberal” emphasis on actionable outcomes of de-stigma, like cultural access (i.e. inclusion, visibility, representation), and legal justice for marginalized people. Some assimilationist discourse endeavors to situate stigmatized identities inside of conformist frames, while (fewer and less visible) others resist dominant frames of acceptability. Contested assimilation and radical leftist de-stigmatization, as well as re-stigma discourses are also discussed.
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There are no systematic investigations of public stigma of hoarding disorder (HD), and although there have been some studies on the public perception of obsessive-compulsive disorder (OCD), such research has not examined three theoretically informed facets of stigma: difference (“They aren't like me”), disdain (“They are bad”), and blame (“They are to blame”). The current Internet study evaluated these three facets of stigma in a general sample of 591 adults by comparing ratings of public perception for HD, OCD, serious mental illness (SMI), substance use disorders (SUD), and those in jail. Results indicate that HD is mostly associated with a neutral or negative public perception across all stigma facets, but OCD is associated with mostly positive or neutral public perception. Across all stigma ratings, HD was viewed more negatively than OCD. Comparison of ratings across conditions and the three facets of stigma suggest a nuanced picture in which HD and OCD demonstrate differences in public perceptions compared to jail, SMI, and SUD, some in the positive direction and some in the negative. In addition, among those who scored in a clinically elevated range of HD symptom severity, one facet of public stigma (i.e., a proxy for self-stigma) was negatively correlated with an index of treatment-seeking willingness, implicating stigma as a potential factor in the treatment ambivalence commonly associated with HD treatment.
Article
Objective On 6 March 2018, the Cleveland Cavaliers power forward Kevin Love penned an op-ed for The Players’ Tribune. In big, bold letters, the title, ‘Everyone Is Going Through Something’ gave way to his proclamation of personal mental health struggles. This study assessed the impact of Love’s personal mental health testimony on the audience. Design Content analysis of Instagram user’s responses to Love’s 2018 announcement of panic disorder. Setting Data were collected on 19 June 2018. Comments on Love’s post were manually copied into an Excel spreadsheet. Due to Instagram’s ‘top comments’ and ‘newest first’ algorithms that determine both the visibility and order of user responses, not all comments were accessible for analysis. A total of 1,234 comments served as the sample. Method Two trained coders analysed the comments for exhibitions of audience involvement with Love, emotional responses and perceptions of social biases surrounding mental illness. Results Social media users who expressed hope were more likely to share their own mental health experiences. In addition, users who expressed hope were significantly more likely to mention wanting to reduce social bias surrounding discussion of mental health than posts without hope. Conclusion Building on previous work that determined social media users can respond to a celebrity’s physical health testimonial with positive, future-oriented emotions, this study established that the same response can exist when analysing a celebrity’s mental health testimonial.
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This article reports on the development of a revised version of the Obsessive-Compulsive Inventory (OCI; E. B. Foa, M. J. Kozak, P. Salkovskis, M. E. Coles, & N. Amir, 1998), a psychometrically sound, theoretically driven, self-report measure. The revised OCI (OCI-R) improves on the parent version in 3 ways: It eliminates the redundant frequency scale, simplifies the scoring of the subscales, and reduces overlap across subscales. The reliability and validity of the OCI-R were examined in 215 patients with obsessive-compulsive disorder (OCD), 243 patients with other anxiety disorders, and 677 nonanxious individuals. The OCI-R, which contains 18 items and 6 subscales, has retained excellent psychometric properties. The OCI-R and its subscales differentiated well between individuals with and without OCD. Receiver operating characteristic (ROC) analyses demonstrated the usefulness of the OCI-R as a diagnostic tool for screening patients with OCD, utilizing empirically derived cutscores.
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This article summarizes research published over the past decade and identifies areas where future research is needed to increase our knowledge of the media's role in fostering or reducing mental illness stigma. The following questions are addressed: (1) How is mental illness portrayed by the media? (2) How do media images of mental illness impact individuals' knowledge, beliefs, attitudes, and behaviors with regard to mental illness? (3) How can the media be used to reduce mental illness stigma? The review reveals a lack of recent research on the U.S. media and a need for precision in how mental illness and the media are defined for study. Research is needed that involves a broader range of media channels as well as more distinctions among different types of content within channels and a more detailed analysis of media images themselves. The largest gap to be addressed is the link between exposure to media images and mental illness stigma. Use of the media as a tool for change requires a better understanding of what messages are conveyed, how they are developed, and what role media content producers play in creating these messages.
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• The Yale-Brown Obsessive Compulsive Scale was designed to remedy the problems of existing rating scales by providing a specific measure of the severity of symptoms of obsessivecompulsive disorder that is not influenced by the type of obsessions or compulsions present. The scale is a clinician-rated, 10-item scale, each item rated from 0 (no symptoms) to 4 (extreme symptoms) (total range, 0 to 40), with separate subtotals for severity of obsessions and compulsions. In a study involving four raters and 40 patients with obsessive-compulsive disorder at various stages of treatment, interrater reliability for the total Yale-Brown Scale score and each of the 10 individual items was excellent, with a high degree of internal consistency among all item scores demonstrated with Cronbach's α coefficient. Based on pretreatment assessment of 42 patients with obsessive-compulsive disorder, each item was frequently endorsed and measured across a range of severity. These findings suggest that the Yale-Brown Scale is a reliable instrument for measuring the severity of illness in patients with obsessive-compulsive disorder with a range of severity and types of obsessive-compulsive symptoms.
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In late 1997, the U.S. Food and Drug Administration (FDA) issued new guidelines that allowed pharmaceutical companies to air prescription drug ads on television. These guidelines have expanded the pharmaceutical industry’s role as one of the major “engines” of medicalization. One arena in which there has been a dramatic increase in direct-to-consumer advertising (DTCA) of pharmaceuticals is the marketing of psychotherapeutic drugs, especially for depression. Because medicalization is thought to reduce blame and stigma attached to deviant conditions such as mental illness, the rise of DTCA for depression drugs may be altering public conceptions of mental illness in general and of depression specifically. The authors examine this possibility by comparing changes in attitudes toward persons with schizophrenia (for which no drugs have been advertised on television) and major depression (the focus of considerable advertising) from 1996 to 2006, 1 year before and nearly 10 years after the FDA’s new guidelines. The authors use the Mental Health Modules in the General Social Survey in these years. Contrary to expectations, despite the surge in DTCA they find no changes in stigmatized views of persons with schizophrenia or depression. However, the public’s beliefs about appropriate treatments for mental illness (regardless of disorder type) shifted further toward medical interventions.
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Researchers have long questioned relationships among self-conceptions, “mental illness,” and stigma. This article looks at these issues through the lens of Obsessive-Compulsive Disorder (OCD), as minimal research has focused on the lived experience of OCD. We examine the impact of OCD on constructions of identity and the management/resistance of stigma. We do this through in-depth interviews with an untraditional Internet-based sample. We find respondents experience a crisis of self that leads them to a variety of strategies to deal with self-stigma, experienced stigma, and anticipated stigma.
Article
The television show Monk, featuring a protagonist who suffers from a serious mental illness, has been singled out for praise by advocacy organizations for its progressive representations of mental illness. Instead of taking the positive reception of Monk at face value, I query the procedures of power that inhabit these anti-stigma discourses and their accompanying media representations. I situate Monk in the context of recent changes in the politics of madness which are part of the contemporary “control society.” Drawing from the conceptual repertoires of Foucault, Deleuze, and others, I contend that Monk's “positive” representations must be read cautiously as discourses that embrace techniques of government—cloaked in the language of freedom—which constitute more subtle exercises of state power. I engage both a close analysis of the show's typical content and an interrogation of the show's broader discursive context, including the show's website and audience forums.
Article
This paper considers some appropriate and inappropriate uses of coefficient kappa and alternative kappa-like statistics. Discussion is restricted to the descriptive characteristics of these statistics for measuring agreement with categorical data in studies of reliability and validity. Special consideration is given to assumptions about whether marginals are fixed a priori, or free to vary. In reliability studies, when marginals are fixed, coefficient kappa is found to be appropriate. When either or both of the marginals are free to vary, however, it is suggested that the "chance" term in kappa be replaced by 1/n, where n is the number of categories. In validity studies, we suggest considering whether one wants an index of improvement beyond "chance" or beyond the best a priori strategy employing base rates. In the former case, considerations are similar to those in reliability studies with the marginals for the criterion measure considered as fixed. In the latter case, it is suggested that the largest marginal proportion for the criterion measure be used in place of the "chance" term in kappa. Similarities and differences among these statistics are discussed and illustrated with synthetic data.
Article
Thomas Scheff's labeling approach to mental illness is based on reactions of other to "residual rule-breaking." This article develops a theory of self-labeling processes to account for the unexplained phenomenon of voluntary treatment seeking. By taking the role of the generalized other, individual can assess the meaning of their impulses and actions. When individuals observe themselves frequently or persistently breaking "residual rules," they attribute disturbance to themselves and may seek professional help. Drawing from Hochschild and Pugliesi, the article reconceptualized " residual rule-breaking" as violations of feeling or expression norms. When individuals are unable to manage or transform deviant feelings, self-attributions of disturbance should result. The conditions under which feeling management attempts are likely to fail and result in self-attributions of disturbance are outlined in the context of a more general theory of emotional processes. Some conditions under which labeling by others ma...
Article
Social science research on stigma has grown dramatically over the past two decades, particularly in social psychology, where researchers have elucidated the ways in which people construct cognitive categories and link those categories to stereotyped beliefs. In the midst of this growth, the stigma concept has been criticized as being too vaguely defined and individually focused. In response to these criticisms, we define stigma as the co-occurrence of its components–labeling, stereotyping, separation, status loss, and discrimination–and further indicate that for stigmatization to occur, power must be exercised. The stigma concept we construct has implications for understanding several core issues in stigma research, ranging from the definition of the concept to the reasons stigma sometimes represents a very persistent predicament in the lives of persons affected by it. Finally, because there are so many stigmatized circumstances and because stigmatizing processes can affect multiple domains of people's li...
Article
The adolescent identity, media, and sociocognitive schema (AIMSS) framework offers a theoretical understanding of adolescent consumption and cognitive processing of media entertainment. Review and integration of mass communication theory, developmental theory, and ecological theory serves as the conceptual foundation. The framework outlines linkages between media exposure and adolescent development, in particular adolescent identity formation and social competence. A key contribution of the model is consideration of the positive and negative aspects of adolescent cognition and behavioral functioning. The present article offers several recommendations for testing the utility of the AIMSS framework. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
People with mental illness have long experienced prejudice and discrimination. Researchers have been able to study this phenomenon as stigma and have begun to examine ways of reducing this stigma. Public stigma is the most prominent form observed and studied, as it represents the prejudice and discrimination directed at a group by the larger population. Self-stigma occurs when people internalize these public attitudes and suffer numerous negative consequences as a result. In our article, we more fully define the concept of self-stigma and describe the negative consequences of self-stigma for people with mental illness. We also examine the advantages and disadvantages of disclosure in reducing the impact of stigma. In addition, we argue that a key to challenging self-stigma is to promote personal empowerment. Lastly, we discuss individual- and societal-level methods for reducing self-stigma, programs led by peers as well as those led by social service providers.
Article
Hoarding has historically been conceptualized as a symptom of Obsessive Compulsive Disorder (OCD); however, data demonstrate important differences between hoarding and OC symptoms (for discussion, see Grisham et al. Anxiety Disorders, 19, 767‑779. 2005). Hoarding has also been observed in disorders besides OCD, including specific Impulse Control Disorders (ICDs; e.g., kleptomania, trichotillomania, pathological gambling, compulsive buying). Therefore, the current study tested the hypothesis that hoarding would be as strongly related to symptoms of ICDs as it is to OCD and that these relationships would be medium to strong in magnitude. Results from an undergraduate sample showed hoarding behaviors were strongly related to symptoms of OCD, moderately related to symptoms of compulsive buying, and more modestly related to symptoms of pathological gambling, trichotillomania, and kleptomania. Finally, findings suggest indecisiveness may be a particularly important underlying feature in hoarding behaviors. These results support the consideration of hoarding outside the confines of OCD.
Article
Theoretical models of public stigma toward mental illness have focused on factors that perpetuate stigma toward the general label of "mental illness" or toward a handful of specific illnesses, used more or less interchangeably. The current work used the Stereotype Content Model (Fiske, Cuddy, Glick, & Xu, 2002) to examine how one facet of public stigma--stereotype content--differs as a function of specific mental illnesses. Participants were recruited online from across the U.S. Study 1 demonstrated that the overarching category of people with mental illness was perceived as relatively incompetent, but not very hostile (i.e., relatively warm). Study 2 found that when the general label of mental illness was separated into thirteen individual disorders, distinct stereotype content toward four clusters of illnesses emerged. One cluster, typified by illnesses with psychotic features (e.g., schizophrenia), was perceived to be hostile and incompetent. A second cluster, comprised of mood and anxiety disorders, was perceived as average on both competence and warmth. A third cluster of illnesses with neuro-cognitive deficits was thought to be warm but incompetent. The fourth cluster included groups with sociopathic tendencies and was viewed as hostile but relatively competent. The results clearly demonstrate that the stereotype content that underlies public stigma toward individual mental illnesses is not the same for all disorders. Harnessing knowledge of differing stereotype content toward clusters of mental illnesses may improve the efficacy of interventions to counteract public stigma.
Article
Anxiety disorders represent the single largest mental health problem in the United States [Greenberg et al., 1999. J Clin Psychiatry 60:427-435; Rice and Miller, 1998. Br J Psychiatry 173:4-9]. However most individuals with anxiety disorders never seek treatment [Henderson et al., 2002. Can J Psychiatry 47:819-824; Mojtabai et al., 2002. Arch Gen Psychiatry 59:77-84; Roness et al., 2005. Acta Psychiatr Scand 111:51-58]. Deficits in the ability to recognize anxiety disorders and beliefs about them, (i.e., "mental health literacy") may contribute to low levels of help seeking. Survey data assessing mental health literacy for multiple anxiety disorders and for depression were collected from 284 undergraduate students enrolled in psychology courses at a public university in the United States. Specifically, respondents were presented with vignettes portraying individuals experiencing various forms of mental illness and were asked to label the disorder, its cause and whether or not they would recommend treatment. Findings showed that social phobia and obsessive compulsive disorder (OCD) were associated with recognition rates that were generally high and similar to depression (approximately 80%). In contrast, less than half of the respondents labeled panic disorder or generalized anxiety disorder (GAD) correctly. Symptoms of OCD were attributed to mental illness by approximately 50% of respondents, but such attributions were rare for the other anxiety disorders studied (<12%). Finally, data on help-seeking recommendations suggested that such recommendations are far from universal and varied between different anxiety disorders and according to perceptions of the causes of symptoms. Given that the current sample was well-educated young adults, mental health literacy of the general public may be even lower.
Article
As its title implies, this article explores a number of unanswered questions and outstanding issues in contemporary audience research. These include: models of the “active audience”; questions of cultural power; global media and transnational audiences; methodologies in audience research; problems of essentialism in the conceptualization of categories of audience members; the strengths and limitations of the encoding/decoding model; models of intellectual progress in the field; the new media and technologies of “newness.” My title is derived from Bertolt Brecht's “Anecdotes of Mr Keuner” in which he extols the virtue of thinking up questions to which we do not have answers (Brecht, 1966). Working from this principle, rather than trying to formulate solutions to the problems of our field, my contribution here is based on questions in media audience research to which I, at least, do not have the answers, as a way of taking stock of what exactly it is that we think we now know about the field.
Article
This article reviews current issues in the diagnosis and treatment of obsessive-compulsive disorder (OCD). The introduction of the selective serotonin reuptake inhibitors and of cognitive-behavioral therapy were significant advances for treating OCD. Nevertheless, there is a need to improve awareness of OCD and its management, and to develop novel approaches to treatment-refractory patients. Although the diagnostic criteria for OCD have remained unchanged for some time, there are several areas where potential modification may be useful. There is a growing evidence base on OCD symptom dimensions and subtyping, and it is timely to consider incorporating some of these emerging data into diagnostic classification systems.
Article
The Yale-Brown Obsessive Compulsive Scale was designed to remedy the problems of existing rating scales by providing a specific measure of the severity of symptoms of obsessive-compulsive disorder that is not influenced by the type of obsessions or compulsions present. The scale is a clinician-rated, 10-item scale, each item rated from 0 (no symptoms) to 4 (extreme symptoms) (total range, 0 to 40), with separate subtotals for severity of obsessions and compulsions. In a study involving four raters and 40 patients with obsessive-compulsive disorder at various stages of treatment, interrater reliability for the total Yale-Brown Scale score and each of the 10 individual items was excellent, with a high degree of internal consistency among all item scores demonstrated with Cronbach's alpha coefficient. Based on pretreatment assessment of 42 patients with obsessive-compulsive disorder, each item was frequently endorsed and measured across a range of severity. These findings suggest that the Yale-Brown Scale is a reliable instrument for measuring the severity of illness in patients with obsessive-compulsive disorder with a range of severity and types of obsessive-compulsive symptoms.
Article
Obsessions are caused by catastrophic misinterpretations of the significance of one's unwanted intrusive thoughts (images, impulses). This chapter explains the development of the behavioral theory of obsessions into a cognitive theory. This theory is based on the work of Clark and Salkovskis. It is based on the facts that unwanted intrusive thoughts are the basis of obsessions and these thoughts are almost universally experienced. It is postulated that obsessions are caused by catastrophic misinterpretations of the significance of one's unwanted intrusive thoughts. By deduction, any increase in such interpretations produces or increases the obsessions. Similarly, any reduction in such misinterpretations is followed by a reduction in obsessions. Evidence and arguments to back the theory are set out. Consideration is given to the precipitants of intrusive thoughts, and then the question of vulnerability to obsessions is addressed. A focused treatment for obsessions is deduced, and it is predicted to produce precise effects and superior results overall. The interaction of depression and obsessions is complex.
Article
Although the benefits of public knowledge of physical diseases are widely accepted, knowledge about mental disorders (mental health literacy) has been comparatively neglected. To introduce the concept of mental health literacy to a wider audience, to bring together diverse research relevant to the topic and to identify gaps in the area. A narrative review within a conceptual framework. Many members of the public cannot recognise specific disorders or different types of psychological distress. They differ from mental health experts in their beliefs about the causes of mental disorders and the most effective treatments. Attitudes which hinder recognition and appropriate help-seeking are common. Much of the mental health information most readily available to the public is misleading. However, there is some evidence that mental health literacy can be improved. If the public's mental health literacy is not improved, this may hinder public acceptance of evidence-based mental health care. Also, many people with common mental disorders may be denied effective self-help and may not receive appropriate support from others in the community.
Article
Aim of the study is to examine the impact of labelling on public attitudes towards people with schizophrenia and major depression. In Spring 2001, a representative survey was carried out in Germany involving adults of German nationality (n = 5025). Labelling as mental illness has an impact on public attitudes towards people with schizophrenia, with negative effects clearly outweighing positive effects. Endorsing the stereotype of dangerousness has a strong negative effect on the way people react emotionally to someone with schizophrenia and increases the preference for social distance. By contrast, perceiving someone with schizophrenia as being in need for help evokes mixed feelings and affects people's desire for social distance both positively and negatively. Labelling has practically no effect on public attitudes towards people with major depression. Our findings illustrate the need for differentiation, differentiation between the different components of stigma as well as differentiation between the various mental disorders.
Article
This article reviews the published literature on the extent, nature, and impacts of portrayal of mental illness in fictional films and television programs. The literature suggests that on-screen portrayals are frequent and generally negative, and have a cumulative effect on the public's perception of people with mental illness and on the likelihood of people with mental illness seeking appropriate help. The article concludes that there is a need for the mental health sector and the film and television industries to collaborate to counter negative portrayals of mental illness, and to explore the potential for positive portrayals to educate and inform, as well as to entertain.
Article
Television portrayals of psychologists may be contributing to an unfavorable perception of mental health services. The present study (N=369) used structural equation modeling to examine the relationship between exposure to television programs, perceptions of therapy (i.e., perceived stigma, anticipated risks and benefits, and attitudes towards therapy), and intentions to seek therapy. The results demonstrated that (a) the relationship between television exposure and attitudes was fully mediated by stigma and anticipated benefits, and (b) the relationship between television exposure and intentions to seek therapy was fully mediated by attitudes, stigma, and anticipated benefits. Furthermore, 54% of the variance in attitudes and 47% of the variance in intentions was accounted for by the variables in the model.
Changing Media Depictions of Mental Illness
  • Ryan P Holliday